12 months or less
1 – 4 years
5 – 10 years
10+ years
Silica dust (e.g., found in most rocks and soil)
Farming chemicals or products (e.g., pesticides)
Aerosols (e.g., paint, hairspray, foams or pepper spray etc.)
Gases or vapours from chemicals or solvents (e.g., cleaning or beauty products, paints, resins, inks, dyes or glues etc.)
Animals and/or animal dander (e.g. animal fur or feathers)
Mould or other microbes (e.g., viruses, bacteria, fungi)
Asbestos
Organic dusts (e.g., hemp, cotton, grain, flour, wood etc.)
Coal dust
Dusts from metals (e.g. cutting, sanding or metal-working operations of cobalt, titanium, iron, aluminium, lead etc.)
Smoke (e.g. fires, extinguishing fires, backburning)
I don’t know what I am exposed to at work
Other
Fumes (e.g., from plastics, rubber, engines)
Please specify:
Choose all that apply:
Yes
No
A new, changed or persistent cough
Blocked and/or runny nose
Coughing up blood or mucus (phlegm)
Chest pain
Chest tightness
Hay fever symptoms (itchy eyes or nose)
Recurrent chest infections
Shortness of breath
I do not currently have any of these symptoms
The same
Better
Worse
Not yet but I plan to
Do you identify as Aboriginal or Torres Strait Islander?
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